bioidentical hormones

Ms. Bliss, Check out the French Cohort Study. It's only the progestin, not the progesterone.

Synthetic Progestin Found to Cause Breast Cancer

A new study published in the October 2010 issue of Journal of the American Medical Association (JAMA) reviewed 11 years of data from the Womens Health Initiative Study. (1) 

Dr.Chlebowski, concluded that the synthetic Prempro Pill used in the study increases breast cancer, and these cancers tend to be the more aggressive. As might be expected, there was also increased breast cancer mortality in the synthetic hormone group. Note: PremPro is made by Wyeth (Pfizer) and is a combination of a horse estrogen- Premarin plus progestin-Provera (medroxyprogesterone).

In an accompanying editorial, Dr Bach comments that finding is , in fact old news, and this increased breast cancer from Progestin, a synthetic hormone, was not surprising to him. Previous studies had anticipated the effect.(2)

Censorship in The Media - Why Can't They Tell You About Progesterone ?

What I find incredible is that neither of the two JAMA articles nor anything in the news  media mentions the fact that Progestins are chemicalized, altered versions of Progesterone.  Nor do any of these articles even mention one word about Progesterone, which is the original human hormone that the drug companies are trying to copy. The synthetic copy is called a Progestin, an inferior, "monster" hormone that causes breast cancer.  Progesterone is safer and more effective than any of the chemically altered progestins.  So why not use progesterone? None of the articles say this. I find this form of self-censorship to be astounding.  Doctors reading this JAMA article will not even think that Progesterone exists.  It does exist.  It is even FDA approved .  Why the silence?

Bioidentical Hormones Are Safer and More Effective Than Synthetics

Progesterone, a bioidentical hormones, is preferable compared to synthetics. Firstly, the WHI Study (Women's Health Initiative Study) showed that synthetic hormones cause cancer and heart disease. If you look at the second arm of the WHI study, (which did not include a synthetic progestin), the breast cancer risk is significantly decreased. The cardiac risk was also decreased. 

Therefore, the Progestin Was the Culprit

The culprit was the synthetic progestin called Provera, known for years to cause cancer and heart disease. As a matter of fact, three previous studies showed the same finding, that progestins cause breast cancer.

1) The Breast Cancer Detection Demonstration Project (BCDDP ) had an increase in breast cancer when they used a progestin.

2) The Swedish Record Review had increase in breast cancer with a progestin.

3) The Million Woman Study had increase in breast cancer with progestin use.

In all these studies, they were using Progestins along with the estrogen, and that's why they got those results. (Progestins are chemically altered synthetic forms of progesterone).

Examples of a chemically altered hormone (see below):
Medroxyprogesterone acetate is a modified version of progesterone, Chemical modification in RED below:




Above left: Bioidentical progesterone...Above Right: chemical modification in RED

A Progestin is NOT Progesterone

Progestin is not the same as bioidentical progesterone. In fact, Progestins are "chemicalized " versions of progesterone. The chemical structure is altered to get a patent. That's why they are so bad for your health. They have been altered chemically.

Breast Cancer Rates Fall After Women Abandon Synthetic Hormones

Secondly, when the WHI results were made public, prescriptions for synthetic hormones dropped and breast cancer rates plummeted. Two separate studies showed these findings: Both in a Canadian Study and a US Study (April 2007 NEJM), data showed plummeting breast cancer rates after the 2002 WHI study prompted massive numbers of women to abandon synthetic hormones.

Bioidentical Hormones Are Not Associated with Breast Cancer
 
The French Cohort Study concluded that bioidentical progesterone was preferable to the synthetic progestins.  They showed no increased risk of breast cancer in bioidentical hormone users (compared to the general population).  (3) 

French Cohort- How Did They Do The Study?  What Did They Find?

The French Cohort Study was done in France. Patient Questionnaires were filled out by 80,000 women.  Over the eight years of follow up, they found 2,354 cases of invasive breast cancer among 80,377 postmenopausal women.  They found that, for the Bioidentical Hormone users (using estrogen plus progesterone), the risk of breast cancer was the SAME or identical to HRT-Never-Users (the same as the general population). 

However, for Synthetic Hormone users (estrogen plus progestin), the incidence of breast cancer was increased by 70 per cent.  Sound familiar?  The authors concluded that it was preferable to use progesterone rather than progestin.  Doing so avoids the increased risk of breast cancer associated with the Synthetic Progestins in the PremPro Pill used in the WHI study (also called Provera-medroxyprogesterone).

Articles with Related Content:

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The Safety of Bioidentical Hormones by Jeffrey Dach MD

The Importance of Bioidentical Hormones by Jeffrey Dach MD

The Evidence for Bio-Identical Hormones The Battle for BioIdentical Hormones by Jeffrey Dach MD

Breast Cancer Prevention and Iodine Supplementation by Jeffrey Dach MD

Bioidentical Hormones and Medical Ghostwriting Links and References

(1) http://jama.ama-assn.org/cgi/content/abstract/304/15/1684 Estrogen Plus Progestin and Breast Cancer Incidence and Mortality in Postmenopausal Women - Rowan T. Chlebowski, MD, PhD; Garnet L. Anderson, PhD; Margery Gass, MD; Dorothy S. Lane, MD; Aaron K. Aragaki, MS; Lewis H. Kuller, MD; JoAnn E. Manson, MD, DrPH; Marcia L. Stefanick, PhD; Judith Ockene, MD; Gloria E. Sarto, MD; Karen C. Johnson, MD, MPH; Jean Wactawski-Wende, PhD; Peter M. Ravdin, MD, PhD; Robert Schenken, MD; Susan L. Hendrix, DO; Aleksandar Rajkovic, MD, PhD; Thomas E. Rohan, PhD; Shagufta Yasmeen, MD; Ross L. Prentice, PhD; for the WHI Investigators
JAMA. 2010;304(15):1684-1692. doi:10.1001/jama.2010.1500

Participants were randomized to receive conjugated equine estrogens, 0.625 mg/d, and medroxyprogesterone acetate, 2.5 mg/d, in a single tablet (Prempro; Wyeth Ayerst, Collegeville, Pennsylvania) or an identical-appearing placebo pill.

Following the initial report of results from the WHI trial,1 a substantial decrease in breast cancer incidence occurred in the United States, which was attributed24-25 to the marked decrease in postmenopausal hormone therapy use that occurred after publication of the trial results.26 The adverse influence of estrogen plus progestin on breast cancer mortality suggests that a future reduction in breast cancer mortality in the United States may be anticipated as well.

In intention-to-treat analysis, estrogen plus progestin compared with placebo increased the incidence of invasive breast cancer (385 cases [0.42% per year] vs 293 cases [0.34% per year], respectively; HR, 1.25; 95% confidence interval [CI], 1.07-1.46; P = .004). Figure 2 also shows quintiles of duration of study intervention based on time of participant entry into study and cessation of study intervention.

A significantly larger fraction of breast cancers presented with positive lymph nodes in the combined hormone therapy group compared with the placebo group (81 [23.7%] vs 43 [16.2%], respectively; HR, 1.78; 95% CI, 1.23-2.58; P = .03).

In conclusion, use of estrogen plus progestin increases the incidence of breast cancer, and the cancers are more commonly node-positive. Mortality data analyses suggest that breast cancer mortality may also be increased. (2) http://jama.ama-assn.org/cgi/content/full/304/15/1719
Postmenopausal Hormone Therapy and Breast Cancer
An Uncertain Trade-off Peter B. Bach, MD, MAPP
JAMA. 2010;304(15):1719-1720. doi:10.1001/jama.2010.1528

In this issue of JAMA, Chlebowski et al10 report results of an 11-year follow-up of WHI estrogen-progestin trial participants that address many of these questions. The authors found that hormone therapy increases the frequency of breast cancer and that the breast cancers are on average more advanced and may be larger.
That breast cancer rates in the WHI increased among women receiving hormone therapy was not surprising. Epidemiological and biological studies had anticipated the effect,5

(3) French Cohort Study Breast Cancer Res Treat. 2008 January ; 107(1): 103-111.
Unequal risks for breast cancer associated with different hormone
replacement therapies: results from the E3N cohort study
Agnès Fournier1, Franco Berrino2, and Françoise Clavel-Chapelon1,*
1E3N, Nutrition, hormones et cancer: épidémiologie et prévention INSERM : ERI20, IFR69, Université Paris Sud - Paris XI, EA4045, Institut Gustave-Roussy 39 rue Camille Desmoulins 94805 Villejuif CEDEX,FR.

Hi MsBliss,

Thanks for your reply!  

For me, the take-away message is this - progestins are not identical to progesterone, although they are synthesized to be as close to natural progesterone as possible.  Some people insist that progesterone is safer than progestins, but as the links above indicate, even progesterone (prometrium) comes with a fairly strong warning about its links to breast cancer, supported by research.  

For me, that's enough evidence to warrant caution and vigilance, but as always it's a personal decision based on risks versus benefits in individual circumstances.  

Hi Mollyann, as I've posted several times in other threads, I don't consider Jeffrey Dach  to be a credible resource at all, and his articles are full of untruths and nonsense, so I won't bother to repeat myself.  However, you refer to the BHRT French Cohort study as evidence that progesterone is safer than progestin, but this part of the study from your link above stands out to me:

"Nondifferential misclassification of HRT exposure, which was based on self-reported
information, may have affected our results, most likely by diluting the magnitude of the relationship between HRTs and breast cancer risk, and reducing any real differences in the effects of different HRTs.

E3N is the first epidemiological study that we know of to be providing results indicating that estrogen-progesterone and estrogen-dydrogesterone combinations may be the LEAST HARMFUL estrogen-progestagen HRTs regarding breast cancer risk. However, more evidence is required before these results can be translated into firm clinical recommendations for the management f menopausal symptoms. In addition, the effect of these combinations in other diseases (e.g., coronary heart disease, venous thromboembolism and colorectal cancer) has also to be evaluated. We therefore encourage further studies and reflection on the links between estrogen- progesterone and estrogen-dydrogesterone HRTs and breast cancer."

For me, saying something is the least harmful is significantly different from saying it is NOT harmful (or even helpful).   Do you interpret it differently?

bump

You may have to scroll back. I'm an enthusiastic long time bioidentical user and researched the subject carefully. My doc is totally onboard but some docs are not as well informed. Also, they don't keep up with the medical conferences. I accompany my sister to these conferences so I get in for free and have learned a lot-- very pro-bioidentical.

Beware: there are the predictable naysayers who chime in on every thread on this forum.

I'm shocked that no one here has even mentioned the work of the late Dr John Lee.  He was the bioidentical hormone researcher who did so much wonderful work.  He wrote "What Your Doctor May NOT Tell You About Menopause" and "What Your Doctor May NOT Tell You About Breast Cancer."  I highly recommend you read the second book if you're at all interested in bioidenticals.  I personally believe that one should get their hormones tested every few months if using any hormones.  That way, one can be sure they're staying balanced.  I believe, after reading Dr Lee's work, that it's not the estrogen that causes problems ... it's the estrogen without progesterone to balance out its effects.  I would not recommend anyone to just slap that cream on without testing periodically.  Being out of balance, either way, I believe can mess us up.

melizzard: I had a tah at age 34 and was on either the estrogen patch or estratest for 15 years but was told I did not need progesterone (no uterus or ovaries). I went on bioidenticals (estrogen/testesterone/progesterone) in January last almost 20 pounds and felt 20 again (wish I had heard of them all these years). Now with the breast cancer dx I was told to stop them. I believe like you said all those years of sticking on a patch with no blood work and not balanced spells trouble ie cancer. I hope once my treatment is finished to return to the bioidenticals where the dosing is made exactly for your body and monitored every 3-6 months. I also read the studies that you need estrogen, progesterone and testosterone to be in balance. I am just upset that I was given synthtic estrogen all those years and was told as long as I didnt take progestrone with it I was fine. Well guess what!! We all want quality of life but we want life too. I wish I knew who to believe.

>>Question: then what is with the PR in the whole ER+/PR+? Doesn't that mean that the tumor was fed BOTH by estrogen and progesterone? Why are we getting treatment only for estrogen? Just a thing that is bugging me.<<

Day, I had those questions too at the beginning of this giant detour in life that has been my journey through bc land.  ....and even though I know a whoooole lot more now than I did then, I have to say I still have these questions today too.  

Some things stick in my brain better than others, but the brief passage in Christiane Northrup's book on women's health still sticks in my brain vividly.  In a nutshell, she describes how estrogen facilitates cells cycling into being,  progesterone cycles them out. Hello!  Why so much focus on estrogen?

When cancer is cells running rampant in overproducing and then sticking around too long, why would anyone think it makes sense to focus on suppressing estrogen?  Why not place some focus on progesterone?  Dr John Lee studied it for decades, wrote about it, and isn't even on the planet anymore, yet progesterone continues to be treated like some fringe element. It bugs me too.  In the world according to ME, progesterone would receive a lot of dollars for research.  

HI everyone, I love this thread. So much data to read and absorb.

I too was on HRT for about 5 years. I took prometrium (considered bio identical) and estrodial patches.  And I felt soooo much better on them. Slept, weight was stable, no hot flashes.  I had very young age of ovarian failure and thus went on the HRT.  I will share while my Onco stated there was higher risk for women on HRT, he didnt blame it and actually told my it was just "bad luck" that I ended up with BC. Perhaps he just didnt want me blaming myself.  

Since  my DX I of course am not on them anymore and dont feel well. The AI, makes hot flashes make me drip sweat, I dont sleep and gained so much weight (20lbs). I have been searching for something to help - started eating right, excercising again - it seems a bit futile. Sleep is elusive.

I wish there was something that could support taking bio -identical as I felt so much better on them. It's all a bit confusing to me.  On the AI, my estrodila blood test shows below 30 , any lower, I can't imagine how much more old and sore and tired I'll be..  UGH. I wish there was an easy answer.

Hi thenewme....well, I just stumbled on your response by accident and quite a bit of time has passed! Anyway, my answer would be this: that there are about 8 researchers in this country that do nothing but study our hormones and even they don't really understand what is going on. There can be no conclusive answer to what is at work with hormone cross talk. That being said, the quote you posted does not really say anything as far as a take home message that I can see.  It seems to be a type of nonspeak that,  "well, the research shows this, but we're not sure, so err in this direction".  The quote even seems to dismiss the notion that there are molecular differences in the types of estrogen under study and distinquishing this would not alter the record.  I cannot take such comments too seriously.

Bump again for relevance to current discussions.

Althea,  my research says we need progesterone to tell "bad" cells to die.  Apoptosis.

My body wasn't making any which is why I supplement.

I must add something here as I feel that using progesterone cream (herbal) may have caused my triple negative B. cancer.  I used it for about 5 years before the diagnosis.  I had zero cancer in my family, zero risk factors, and exercised and ate right.  There was no reason for my cancer, except the fact that I was using progesterone cream, by reading Dr. Lee's book.  I had some minor menopausal symptoms such as thinning hair, frequent bathroom trips, and those were the reasons I was using progesterone for. I feel that before menopause, it maybe okay to use, but after menopause, it is a definite NO NO.  Reading about it convinced me that it was only herbal, won't do much harm, but when I try to narrow down all the things that might have caused my BC, it only seems to point to this one thing.  His was only a theory and not scientifically proven even till today.

Haven't read ALL the posts here, but I did read Deanna's.

Yes, I am one of the women who took bio-identical hormones, after being dx'd with premature ovarian failure, at age 35.   Now, having said that, I didn't start the bio-identical hormones til I was about 40 years old....  at age 43, I was dx'd with breast cancer, IDC, stage 1, grade 2.... ER+/PR+/Her2- negative....

I think hormones are hormones and they contributed to my cancer...

Harley

I talked to my onc about BHRT last week at my 6 month check up....he goes...you're not taking estrogen or progesterone!!!  I agree that HRT and BHRT do the same thing....BUT I am looking at other types of BHRT such as testosterone and DHEA...Still waiting on my labs....I only took the pill for a handfull of years in my 20's and then only for a couple months in my 40's to help with peri-menopause....the side effects were awful...and that was only 3 or 4 years before Dx.....But I did take progesterone with 4 out of 7 pregnancys....and I've wondered if that had anything to do with Dx.....but my kids were  turning 8, 17 and 20 at time of Dx so not that recent in comparison to dx.....but something the "BHRT" doc said it indicated that my hormones had been out of balance for year.....I was Dx with leuteal phase deficiency after a 2nd miscarriage.....or is the BC just because I'm a woman and 8 out of 100 of us are Dx in our lifetime....I"m not looking to find a reason for Dx....I'm looking to find a solution to my side effects from chemo, AI's and menopause....doesn't matter to me why I got BC....can't change that but I hopefully can change how I feel.....can I get back my libido, my zest for life and all those other things important to living a full life!!!

Hi Ladies: Great comments. I am soooooo tempted to start back on my bioidenticals. I was on birth control for 12 years and then had an complete hysterectomy at 34. I then took synthetic estrogen (estrase) for 14 years. I had jsut switched to bioidenticals for 6 months including estrogen, progesterone and testosterone when I was diagnosed. Obviously it was not the bioidenticals that caused my ca. I have done hours and hours of research. Most of the new reasearch says bioidenticals are safe and some do say say safe with hx of cancer and to prevent reoccurances. Saying that my tumor was 92% estrogen and 97% progesterone positive. But I did not have any progesterone in my body for 14 years. So its all very confusing to me. And I can say all my doctors except one who is a naturalist say NO hormones. The one who really studies and practiced homeopathic medicine says it is safe. I am very confused. I am not taking any of the hormone supression medication. I wish someone could tell me if I needed progesterone for my tumor to grow how it could have with no progesterone.

I really want to go back on my testosterone pellets so much.  I understand that going back to my Bioidentical estrogen pellets may not be advised, but I think I can safely take the testosterone pellets if I am on Tamoxifen to cover the small amount that may be converted to estrogen by my body.  I am so tired of the terrible night sweats, body aches and zero libido that I have without the testosterone.  Wish I knew what to do.  Quality of life is important to me, but I'm afraid of feeding a new cancer down the road too.......